Background. Treatment results for the patients with stage II–III triple negative breast cancer (TN BC) have to be improved. Not only the new treatment regimens, but new predictive and prognostic factors should to be developed.Materials and methods. We included 98 patients with stage II–III TN BC in our study. We studied efficacy and safety of PlaTax regimen (cisplatin 75 mg / m2 day 1 + paclitaxel 80 mg / m2 days 1, 8, 15, course every 4 weeks) in this cohort of patients. We assessed pathologic response, survival and factors, which were relevant for predicting response and prognose survival.Results. PlaTax regimen is characterized by high efficacy and tolerable toxicity. Clinical efficacy was 85.8 %, pCR achievement was 60.5 %, tpCR achievement was 58.1 %. The regimen has low haematological toxicity (neutropenia III–IV grades – 4.1 %); the most frequent adverse events were polyneuropathy (18.5 %) and decreased renal function (24.5 %). 3-year progression-free survival was 68.4 %, most of the relapses (92 %) occurred during first 2 years. 3 year overall survival was 77.6 %. The most relevant predictive factor was level of Ki-67 ≥50 % (pCR 38.5 % vs. 68.7 %, p = 0.038). pCR achievement was the most important prognostic factor, resulting in improved 3-year progressionfree survival (44.3 % vs. 89.1 %, p <0.0001), and 3-year overall survival (61.5 % vs. 91.6 %, p = 0.001). Not only the residual disease, but also the size of residual tumor was important from prognostic point of view. Other important prognostic factors were size of the tumor, status of regional lymph nodes, grade. Delay in surgical treatment more than a month lead to decreased 3-year progression-free survival: 87.1 % vs. 62.5 % (p = 0.047).Conclusions. Our data suggest that studied regimen could be an option for patients with stage II–III TN BC. The assessment of the predictive and prognostic factors will help improve the treatment results for patients with stage II–III TN BC.
The article considers the place of nab-paclitaxel in the treatment of metastatic breast cancer. A number of studies have shown high efficacy and acceptable toxicity in comparison with traditional taxanes. The low frequency of hypersensitivity reactions allows the use of nab-paclitaxel in patients who had reactions with the introduction of traditional taxanes and in the presence of contraindications to corticosteroids premedication. The absence of cross-resistance makes possible to prescribe nabpaclitaxel in patients who had progression on treatment with paclitaxel and docetaxel. The cases of effective use of the drug from our own practice are presented.
Анемия является распространенным гематологическим осложнением у онкологических пациентов, получающих химиоте-рапию. Снижение уровня гемоглобина сопровождается значительным ухудшением качества жизни пациентов. В случае развития симптомной анемии с целью быстрого увеличения уровня гемоглобина применяется переливание эритроцитар-ной массы. Однако большое число рисков ограничивает широкое применение гемотрансфузий. Препаратами, которые позволяют снизить потребность в гемотрансфузиях, являются эритропоэзстимулирующие протеины. Эритропоэтины обе-спечивают плавный и пролонгированный подъем уровня гемоглобина, выход в кровь функционально полноценных эри-троцитов. Использование эритропоэтинов позволяет значительно улучшить качество жизни онкологических больных, не снижая эффективности проводимой химиотерапии.
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